Brodifacoum rodenticide ingestion in a patient with shigellosis

Factitious disorders are characterized by the intentional feigning or induction of signs and/or symptoms in order to assume the sick role. The spectrum of diseases and symptoms simulated is extensive. Although some patients may seek only the gratifications of the sick role, typically patients seek health care for their afflictions. We report the case of a woman with a history of numerous unexplainable illnesses and laboratory findings who had shigellosis. On routine evaluation, a severe prothrombin coagulopathy was discovered and later determined to be caused by brodifacoum, a "superwarfarin" drug found in potent rodenticides. The patient was successfully treated with daily vitamin K. She continued to deny intentional or accidental ingestion but did consent to psychiatric treatment.